Seiko Katsumura

Factors affecting the oral condition of patients with severe motor and intellectual disabilities

BACKGROUND Handicapped persons living in nursing homes have special risks for oral diseases. OBJECTIVE To investigate the specific factors related to the occurrence of dental caries and tooth extraction in patients with severe motor and intellectual disabilities (PSMI) residing in an institution. METHODS One hundred eighty-nine PSMI residing in a single institution in Japan were followed for 3 years. Oral examinations were conducted at baseline and 3 years later. The following items were investigated: age of subject at admission, period of institutionalization, age at baseline oral examination, status of rumination, drooling, type of ward, dietary mode, and etiology of the impairment. Logistic regression analyses were conducted to examine factors associated with new dental caries and tooth extraction occurring during the study period. RESULTS By multivariate analysis, rumination and tube feeding were identified as significant factors associated with new dental caries. On the other hand, infancy or childhood impairment and drooling were identified as significant factors related to tooth extraction. CONCLUSION Some specific factors in this patient population affect the dental caries and tooth extraction and oral programs targeting these factors may reduce dental degeneration in these patients.

Evaluation of risk factors for dental caries from 6 to 8 years old children

The aim of this study is to evaluate the risk factors for dental caries in young children in Japan. We studied 645 children attending 13 of 30 elementary schools in two areas in Japan. Total salivary level of mutans streptococci and lactobacilli were evaluated at pre-school medical check-ups. Other factors we evaluated included use of fluoride containing dentifrices, administration of fluoride varnish in a private dental office, having regular check-ups, use of mouthwash with fluoride, and daily intake of sweet juice or snacks. Oral examinations were carried out at annual medical check-ups with 2.5 years follow-up and finally 585 children were analyzed. By multivariate logistic regression analysis, only three factors; gender, salivary levels of mutans streptococci and the presence or absence of dental caries in deciduous teeth had a statistically significant correlation with the incidence of dental caries after 2.5 years of follow-up. At age 8, odds ratios were 1.821 for female gender, 1.259 for mutans streptococci (log10 cfu/ml) and 2.262 for dental caries in deciduous teeth. Although the prevalence of dental caries has declined in Japan, mutans streptococci remain a risk factor.

A randomized controlled trial by the 3DS for dental caries

Abstract The aim of this study is to evaluate the povidone-iodine for the suppression of oral cariogenic bacteria and compare its effects to that of fluoride in children. We carried out a randomized controlled trial to compare the effects of povidone-iodine to those for sodium fluoride. Pre-school children (n=210) with more than 10 5 cfu/m l mutans streptococci in their stimulated saliva were randomly sampled and randomly allocated into three groups. We planned the preventive program by 3DS (Dental Drag Delivery System). The groups that provided preventive programs were the povidone-iodine group (n=70) and the sodium fluoride group (n=70). A control group (n=70) received no intervention. Povidone-iodine or sodium fluoride was applied to the tooth surface using custom made trays. Subsequent home care was obligatory for one month. After one month, the salivary levels of mutans streptococci were low level when compared to the based data. However the difference in salivary levels of mutans streptococci among groups was not statistically significant when comparing the povidone-iodine group with the sodium fluoride group ( P =0.625). After 2.5 years follow up, differences in incidence of new dental caries among the three groups were not statistically significant ( P =0.583). Clinical application of anti-microbial drugs may be effective, but only a single intervention is not sufficient to reduce the incidence of new dental caries.

Fluoride-containing mouthrinses in three European countries

The caries-preventive effect of fluoride is well known. The widespread use of fluoride-containing toothpastes and mouthrinses has been recommended to reduce dental caries. Many kinds of fluoride containing toothpastes are available in Japan. However, only two kinds of mouthrinses which contain fluoride are comically available. The aim of this study was to investigate the current status of fluoride-containing mouthrinses on the market in three European countries. Fluoride-containing mouthrinses were purchased from retail outlets in Athens, Amsterdam and Geneva. The labels of ingredients were studied to determine the type and concentration of fluoride. Most of the mouthrinses contained sodium fluoride (90%); some contained stannous fluoride (5%) or potassium fluoride (7%). The concentrations of fluoride ranged from 100 ppm to 500 ppm.

Cervical curvature variations in patients with infraocclusion

The purpose of this study was to observe the variations of cervical curvature in patients with infraocclusion, and to compare this with the controls. In this study, the infraocclusion criteria were defined with the Pr-id as <17 mm on the cephalometric image. The subjects were 32 patients with infraocclusion, and 28 controls which matched the distribution for gender and age. The six points of inquiry were as follows: (i) cervical vertebra height, (ii) neck alignment, (iii) ratio of lower facial height, (iv) vertical dimension of occlusion, (v) cervical angle and (vi) occlusal angle. In over 90% of the patients with infraocclusion, the cervical curvature was classified as straight or kyphosis. Conversely, in 36% of the control subjects, the cervical curvature was classified as lordosis. There was a weak positive correlation between the vertical dimension of occlusion and the cervical curvature in all subjects. In the control group, there was a significant and strong positive correlation between the age and cervical curvature, and a strong negative correlation between age and cervical angle and occlusal angle. Conversely, in the patients with infraocclusion, age was only correlated with the ratio of lower facial height. The prevalence of non-lordosis in the patients with infraocclusion was higher in comparison with the control group in our study, and the previous large-scale study of Japanese. However, there was merely a weak positive correlation between the cervical curvature and the vertical dimension of occlusion.

Effectiveness of a radiology-anatomy instructional module in a clinical course on oral radiology

ObjectivesAn insufficient knowledge of anatomy often complicates the interpretation of radiological findings by students learning clinical medicine. During a 3-week clinical course in oral radiology, students attended lectures on anatomy for half of each day. Our objectives were to evaluate this program and determine why some students remained unmotivated to learn anatomy.MethodsSurveys were carried out using two questionnaires, one for evaluating the students’ beliefs regarding the necessity of knowing anatomy and their understanding of radiology and anatomy, and the other for determining the value of the educational program. In total, 126 questionnaires were analyzed. Structural equation modeling and decision analysis were used to analyze the data obtained.ResultsBeliefs regarding the necessity of knowing anatomy were explained by three variables: the necessity of knowing imaging anatomy, the necessity of knowing gross anatomy, and understanding of anatomy. Awareness of the necessity of knowing anatomy and understanding of graphical images were not strongly correlated. The educational program was characterized by two factors: “value” and “appropriateness” These were strongly correlated. Student interest in the content of the course was found to be the most important factor in student evaluations of the educational program. Students who answered “agree”, “disagree” or “strongly disagree” to three items, “interested in the content of the course”, “obtained knowledge through the course” and “expected the course to be useful in the near future” were likely to have insufficient understanding of and awareness of the necessity of radiology and anatomy.ConclusionsThe inclusion of lectures on anatomy is beneficial for improving student understanding of oral radiology. Student interest in the content is important in evaluations of radiology–anatomy programs.

Fluoride-containing toothpastes available in two European countries

The caries-preventive effect of fluoride is well known. The widespread use of fluoride-containing toothpastes and mouthrinses has been recommended to reduce dental caries. Many kinds of fluoride-containing toothpastes are available in Japan. The aim of this study was to investigate the current status of fluoride-containing toothpastes on the market in two European countries. Fluoride-containing toothpastes were purchased from retail outlets in Cardiff, United Kingdom, and Frankfurt, Germany. The ingredients labels were studied to determine the type and concentration of fluoride. Most of the toothpastes contained sodium fluoride (56.4%); some contained monofluoroacetic sodium (31.7%), stearyl trihydroxyethyl propylenediamine dihydrofluoride (1.0%), aluminium fluoride (1.0%), stannous fluoride (2.0%), or amine fluoride (5.0%). The concentration of fluoride in these products ranged from 800 to 1,500 ppm.